chp 21 skin infections worksheet - no answers-1

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Jan 9, 2024

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BIO208 – Infectious Diseases of the Skin, Chapter 21 How do each of the following protect the skin from pathogens? • Sebum- it inhibits the growth of microbes and contains lipids and fatty acids • Sweat- contains salt, lysozyme, and antimicrobial peptides that inhibit microbe growth • Stratum corneum (skin surface layer)- the exterior surface of the skin made up of dead skin cells, dry and sloughs of dead cells, which both prevent microbe growth • Lysozyme- catalyzes the hydrolysis of peptidoglycan linkages, an antimicrobial enzyme that is present in sweat, tears, and saliva • Normal microbiota- prevents the growth of pathogenic microbes by competing for space and nutrients called microbial antagonism • Low pH- prevents the growth of microbes that require a neutral or high pH to grow; only acidophiles can grow at low pH The development of comedones occurs during puberty when hormone production leads to excess sebum that blocks pores. How does this contribute to the growth of P. acnes ? A. Sebum prevents air from getting to pores, which promotes growth of P. acnes. B. P. acnes releases exoenzymes to migrate through sebum. C. As P. acnes destroys sebum, it releases acid that lowers the pH of the environment. D. P. acnes represses the inflammatory immune response E. Sebum prevents air from getting to pores, which promotes growth of P. acnes AND P. acnes can digest sebum for nutrition. Case study 1: Leili, a 3-year-old girl, was brought to the pediatrician by her mother, who was worried about the rash on Leili’s lip. It started 4 days earlier as a little bump above her lip that spread to the corner of her mouth. The base of the rash was red and covered by pustules. The little girl said that her rash hurt, and the clinician noticed a honey-colored crust on the ruptured pustules. Leili’s mother said that her daughter had not been trying to scratch the rash nor was the area around it hot to the touch. Based on the information, what disease does Leili have? What is the causative agent? Leili has impetigo which is a skin infection often caused by bacteria called staphylococci or streptococci. What tests can be performed to confirm the diagnosis? You could swab one of Leili’s sores and send it to the lab so that the causative agent and antibiotic susceptibility can be identified. If it is positive catalase then its SA and if there is hemolysis and bacitracin sensitivity then its SP. 1

What precautions would you offer to Leili’s mother to prevent spread of the disease? Since impetigo is very contagious, I would give Leili’s mother a topical antibiotic to use. It is best to treat it orally because it will reduce the chance that the bacteria develops drug resistance. Also, because Leili’s cause is mild the antiobotic gel should be able to penetrate the pustules easily and kill the organism. Case study 2: Your patient is a 17-year-old adolescent who sustained a cut on his thumb playing lacrosse. The school nurse dressed it and used Polysporin on the lesion. Within a week, the site of the cut was red, raised, and sore to the touch, with pus developing. The patient was also experiencing a low-grade fever. You took a swab and cultured it on mannitol salt agar, and you also Gram stained the resulting colonies. The results are as shown here in these images. You performed an antibiotic sensitivity test and discovered no zones of inhibition around the antibiotic discs. A catalase test was positive, as was a coagulase test. What is your diagnosis of the infection, given the Gram stain, the nature of the lesion, and the test results? A. Impetigo B. SSSS C. MRSA D. Acne What additional test would be advantageous to confirm your initial diagnosis? A. Rapid diagnostic test (DNA) B. Blood test C. Catalase test D. Bacitracin sensitivity test E. Whole genome sequencing In light of your discovery, how would you treat this patient? A. Multidrug regimen of antibiotics B. Antiviral such as Valtrex C. Antifungal such as miconazole D. Recommendations for good hygiene E. Rapid diagnostic test 2

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